What is acalculous cholecystitis?
Acalculous cholecystitis is a type of cholecystitis characterized by inflammation of the gallbladder in the absence of gallstones. While most cases of cholecystitis are associated with gallstones, acalculous cholecystitis can occur due to various underlying factors, including trauma, critical illness, infections, ischemia (reduced blood flow), or obstruction of the cystic duct without the presence of stones.
What are the symptoms of acalculous cholecystitis?
Symptoms of acalculous cholecystitis are similar to those of cholecystitis associated with gallstones and may include:
- Persistent, severe pain in the upper right abdomen that may radiate to the back or shoulder blades.
- Nausea and Vomiting
- Fever
What causes acalculous cholecystitis?
Acalculous cholecystitis can occur due to various underlying factors, including:
- Critical Illness: Patients who are critically ill or hospitalized for prolonged periods may develop acalculous cholecystitis due to factors such as reduced blood flow to the gallbladder, decreased bile secretion, or impaired gallbladder motility.
- Infections: Bacterial infections, particularly in the setting of systemic infection or sepsis, can lead to inflammation of the gallbladder.
- Trauma: Traumatic injuries, such as blunt abdominal trauma or surgical procedures, may cause inflammation or injury to the gallbladder.
- Ischemia: Reduced blood flow to the gallbladder, often associated with conditions such as cardiovascular disease or shock, can lead to ischemic injury and subsequent cholecystitis.
Diagnosis and Treatment of Acalculous Cholecystitis
Diagnosing acalculous cholecystitis typically involves a combination of medical history review, physical examination, laboratory tests, and imaging studies such as ultrasound, CT scan, or MRI.
Once diagnosed, treatment for acalculous cholecystitis aims to relieve symptoms, address underlying causes, and prevent complications. This may include:
- Nonsurgical Management: In mild cases, conservative treatment measures such as fasting, intravenous fluids, pain management, and antibiotics may be sufficient to resolve symptoms and inflammation.
- Surgical Intervention: In severe or recurrent cases, surgical removal of the gallbladder (cholecystectomy) may be necessary to alleviate symptoms and prevent complications.